Betacoronavirus, Coronavirus Infections epidemiology, Coronavirus Infections metabolism, Dehydration epidemiology, Dehydration metabolism, Dehydration prevention control, Diabetes Mellitus, Type 1 epidemiology, Diabetes Mellitus, Type 1 metabolism, Diabetes Mellitus, Type 2 epidemiology, Diabetes Mellitus, Type 2 metabolism, Diabetic Ketoacidosis epidemiology, Diet Therapy, Disease Management, Fasting adverse effects, Fluid Therapy, Humans, Hyperglycemia epidemiology, Hyperglycemia metabolism, Hyperglycemia prevention control, Hyperglycemic Hyperosmolar Nonketotic Coma epidemiology, Hyperglycemic Hyperosmolar Nonketotic Coma metabolism, Hypoglycemia epidemiology, Hypoglycemia metabolism, Hypoglycemia prevention control, Hypoglycemic Agents therapeutic use, Ketosis epidemiology, Ketosis metabolism, Pandemics, Pneumonia, Viral epidemiology, Pneumonia, Viral metabolism, Risk Assessment, United Kingdom, Diabetes Mellitus, Type 1 therapy, Diabetes Mellitus, Type 2 therapy, Fasting metabolism, Holidays, and Islam
The month of Ramadan forms one of the five pillars of the Muslim faith. Adult Muslims are obligated to keep daily fasts from dawn to sunset, with exceptions. This year Ramadan is due to begin on 23 April 2020 and the longest fast in the UK will be approximately 18 hours in length. In addition, due to the often high-calorie meals eaten to break the fast, Ramadan should be seen as a cycle of fasting and feasting. Ramadan fasting can impact those with diabetes, increasing the risk of hypoglycaemia, hyperglycaemia and dehydration. This year, Ramadan will occur during the global COVID-19 pandemic. Reports show that diabetes appears to be a risk factor for more severe disease with COVID-19. In addition, the UK experience has shown diabetes and COVID-19 is associated with dehydration, starvation ketosis, diabetic ketoacidosis and hyperosmolar hyperglycaemic state. This makes fasting in Ramadan particularly challenging for those Muslims with diabetes. Here, we discuss the implications of fasting in Ramadan during the COVID-19 pandemic and make recommendations for those with diabetes who wish to fast.
(© 2020 Diabetes UK.)